Objective: To determine the efficacy of prophylactic tranexamic acid in reducing hemorrhage after vaginal delivery as compared to placebo 

Design: A randomized controlled trial was conducted at department of OBGYN Al-Nafees Medical College and Hospital, Islamabad from 01-07-2020 to 31-12-2020.

Method: A total of 258 patients of age group between 18-40 years, parity 0-4 with singleton pregnancy at gestational age 37-41 weeks were enrolled after informed consent through non-probability consecutive sampling. Randomization was carried out by lottery method. Prophylactic 1 gm tranexamic acid, or placebo (10ml distilled water) intravenously immediately administered after delivery but definitely within 30 minutes. Every participant received the medication according to their allotted groups intervention or placebo, ensuring blinding of patients and the treating physician. All patients were followed for 72 hours and efficacy (yes/no) was noted by determining hemoglobin and hematocrit values 72 hours post-delivery. 

Results: The mean age of the patients was 28.59±4.63 years in intervention group while the mean age of the patients was 28.21±5.42 years for placebo group. Postpartum hemorrhage was 7.8% in intervention group as compared to 21.7% in placebo group (p-value=0.002). The mean blood loss was 705.00±186.26 ml in intervention group in comparison to 791.07±137.47 ml in placebo group (p-value=0.131). 

Conclusion: This study concluded that prophylactic Tranexamic acid is significantly more efficacious in reducing hemorrhage after vaginal delivery as compared to placebo